The fact of the matter is that gifts, large and small, play an important role in medicine on a number of levels. I think that this is especially true as concerns research, as we saw last week in the Fishman piece in particular. The “larger” gifts are known by another name as “research grants” and add another layer of conflict of interest. This was particularly evident to me in the “Acknowledgment of Financial Support” disclaimer at the end of the Katz et al. article: “[t]his research was partially sponsored by an unrestricted gift from Pfizer, Inc., to the University of Pennsylvania Center for Bioethics” (44, emphasis mine). I highlight the word gift because I find it to be an interesting word choice. When we consider this gift from Pfizer, we could on the one hand discuss how great it is that they are supporting bioethical research. On the other hand, I have an image of an ulterior motive from Pfizer: “Look, we sponsored a study on small gifts, obviously we’re supporting academic thought in this area, but while they figure out the policy stuff, here’s a keychain.”
While I do realize that these articles dealt more with the notion of smaller gifts and how they seem to get carte blanche in terms of conventional conflict of interest discussions, I find it interesting that there is an equal sort of “pass” being given to academics who accept similar gifts. It seems adequate, at this point, to put a disclaimer. This is not to say that the researchers themselves are not reflexive of this fact. Funding is hard to come by and forms a challenging part of the research process. This could probably not be said of a physician’s ability to obtain sticky notes that aren’t stamped with branding. My main concern with the articles was that I felt that they didn’t necessarily have a tangible solution for some of the issues they dealt with, whether it be in terms of policy, physician training or so on. I worry that this issue could persist if discussions on the issue are themselves funded by “gifts”.